Nattokinase: What 46 Years of Research Actually Shows
Dose, blood pressure, carotid plaque, brain health and bleeding risk, graded by evidence tier. By Dr. Frank Yap, MD | Last Updated October 2026 Quick Answer Nattokinase is a clot-dissolving enzyme made by Bacillus subtilis during natto fermentation. Its best-supported human effect is a modest blood pressure drop (about 3 to 5 mmHg systolic) in randomized trials. Plaque regression has been reported only at 6,000 FU/day or higher, in studies that were unblinded or retrospective, while the largest placebo-controlled trial at 2,000 FU/day was null. No trial has measured heart attacks, strokes or deaths. It acts on clotting, so it should not be combined with blood thinners without a clinician, and it must never replace a prescribed anticoagulant. Contents What nattokinase is How it works Human evidence table (CEBM tiers) Blood pressure Plaque and the dose question Cholesterol Brain and stroke research Spike protein claims Natto the food vs. the enzyme Safety, inte...